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The Black Box of Mental Health

The Black Box of Mental Health

Why it’s hard to get help and why you are not helped…much with mental health problems.

Mental health problems are like the black box in an aeroplane, we all know it exists, but we have no idea what’s in it or exactly how it works. We know anxiety exists, as does depression, but what are they really? We know the labels for things but not what the labels signify. This presents us with a problem because, without adequate language to explain and to understand a problem, it is very hard to know how to resolve it.

I was interviewed on BBC radio yesterday about emotional burnout, which seems to me to be simply a different name for chronic stress. Nevertheless, the presenter’s questions were focused on what can be done to combat emotional burnout, as if the assumption of its existence was ‘given as read’. There seems to be little interest in the fact that mental health issues are ubiquitous, in all developed countries, and significantly rising in many, and that mental health problems probably arise as much from political decisions as they do from health decisions. There is little appetite in the media for anything other than reporting on the latest statistic. This leaves the life sapping problems of anxiety and depression to continue to grow unhindered.

Let me give you an example, between 2008 and 2018 anxiety in females in the age group 18-24 tripled to 30.33%. In only ten years, the quality of life of a third of that population was seriously damaged. Note; these data were compiled before Covid-19 was even a possible threat. My expectation is that these figures will be even higher now and will continue to rise for some time yet.

Where is the outcry at this plunge in wellbeing? Personally, I think it is a scandal. Who in power seems to care? However, I do not believe those in power are wilfully neglectful nor callous. I think they struggle to help because they posses the same problems of all societies. My experience suggests that there isn’t an appropriate language to describe what anxiety and depression really are. We only see the container not the contents!

My professional opinion is that we lack an appropriate social discourse that enables us to speak meaningfully and helpfully about mental health problems. It’s not about stigma, as we may be led to believe, it’s about the way the knowledge of mental health problems is discussed, taught about and described. In fact, it simply isn’t.

As an example, irrespective of what you think you know about history or geography, I am certain you know more about those subjects than you do about how to recover from anxiety and depression. Am I right? What does that tell us? Even schools lack the means to teach and provide our youth anything practically useful regarding how to recognise and resolve mental health problems. 

One reason for this lack of discourse, I believe, is that the medical model of mental illness has had difficulty in developing a non-medical language that actually describes the processes inherent in mental illness without falling back on simple symptom listing. This is because the process of defining symptoms is inherently natural and even easy. Whereas the psychological processes underlying change, beyond the physical, remains intangible and therefore inhibits recovery. Without a meaningful and productive language about depression and anxiety we can’t grasp them as simply problems to solve. Hence, the funnelling of sufferers of psychological/mental health problems to an overtly biological/physical interpretation of symptoms and the over-prescription of psychiatric drugs. This approach is a poor attempt at a solution and is responsible for the rising prevalence of mental health problems and high relapse rates from anti-depressants, despite record levels of prescriptions for anti-depressants.

I suggest that we don’t have language in common use to describe anxiety beyond the ordinary. Go on have a go! Typically, you have to resort to symptoms you or others experience or how much it has cost you in terms of time off work, loss of income or opportunity. In essence, you can describe the shape and texture of the black box but not its contents. This means that you are lost without the right language to describe your experience in a way that is useful so that you can help yourself. The same applies to panic, stress, OCD, social anxiety, indeed every mental health problem suffers from this lack of a suitable language. Without a useful language of understanding and problem solving, society and individuals struggle to know how to help. This is why help typically devolves to the lowest common denominator of medication, or a therapist to help you understand and resolve your problems. I make my living providing one to one therapy and I know it is powerful and it works but there is a limit to how many people I can see. So no matter how hard I or other therapists work, we will not make a difference to the rapidly rising rate of mental health problems.

The burden of poor mental health spreads and increases throughout society without any effective or meaningful attempt to do anything different to reverse this situation. These same old solutions remind me of Nero playing his Fiddle while Rome burned; irrelevant to the problem. Likewise, doing the same thing over and over and expecting a different outcome, the very definition of stupidity.

Politicians can talk endlessly on television and radio about their policies and about what's wrong with other peoples’ policies until it becomes more of the same, endless chatter. Nevertheless, you can participate, and you can understand the different points of view. You can contribute. You feel you have some grasp of the issues and the language to express your views. But when people talk about mental health problems, they either talk about them from their own personal perspective, which is interesting but idiosyncratic, or they talk about the research, which probably encompasses whole populations and, although interesting, it doesn't connect to the individual and doesn't help the individual understand what the problem is that they're struggling with or how to fix it.

There is a gap between epidemiological research on the wider population and the lived experience of each individual. That gap is the problem hampering so many people recovering from recoverable mental health problems. That gap needs to be filled with a narrative that is understandable sensible relevant accurate and useful. Psychotherapists and counsellors require you to have face to face sessions. Hypnotists require you to take sessions of hypnosis. CBT therapists require you to have sessions of CBT therapy. Psychiatrists require you to take medications. All professional helpers place themselves in that space between your experience and the knowledge base they posses. If it is psychotherapy, they teach you something about that space and you learn from them and then you recover. You don’t learn all they know, but hopefully you learn enough to improve your quality of life. With a medication you learn nothing and probably don’t recover, although the problems you struggle with may seem more manageable. This is why I have spent years developing a useful narrative and practical frameworks in Self Help CBT.

Without a narrative that encompasses problem formation, problem maintenance and problem resolution, how can you feel you understand your mental health problems? Personally, I just don’t think you can. It is simply not possible to understand things for which you have no effective vocabulary.

If you want to be a member of the small minority of people who both understand mental health problems and are working to leave them behind to improve their quality of life. I suggest you delve into Self Help CBT with me.

It’s not that complex and it’s not that time consuming. It is certainly not that expensive! It is life changing. Don’t expect life change to come to you. You have to make it happen now.

Join Anxiety Wizard and start to make sense of it all.